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High COVID-19 Attack Rate Among Attendees at Events at a Church - Arkansas, March 2020
Insights
A church outbreak in Arkansas led to 35 COVID-19 cases and 3 deaths among 92 attendees. This highlights the risk of transmission at group gatherings and the need for faith-based organizations to follow public health guidance.
Area of Science:
- Epidemiology
- Public Health
- Infectious Disease
Background:
- The first cases of coronavirus disease 2019 (COVID-19) in a rural Arkansas county were identified in March 2020.
- The index cases, a married couple, attended church events prior to symptom onset.
Purpose of the Study:
- To investigate a COVID-19 outbreak linked to a rural church in Arkansas.
- To understand transmission dynamics within a faith-based community and the broader community.
Main Methods:
- Descriptive epidemiology and contact tracing were employed.
- Case identification and data collection focused on attendees of church events and their contacts.
Main Results:
- 35 confirmed COVID-19 cases (38% attack rate) occurred among 92 individuals attending events at Church A.
- Three deaths were reported among church attendees; an additional death occurred in a community member infected by an attendee.
- Age-specific attack rates varied, with higher rates in adults aged 19-64 (59.4%) and ≥65 (50.0%) compared to those ≤18 (6.3%).
Conclusions:
- Group gatherings at faith-based organizations can facilitate widespread transmission of SARS-CoV-2.
- Faith-based organizations play a crucial role in preventing COVID-19 by adhering to public health guidelines.
- Community transmission occurred secondary to the initial outbreak at the church.
Abstract:
On March 16, 2020, the day that national social distancing guidelines were released (1), the Arkansas Department of Health (ADH) was notified of two cases of coronavirus disease 2019 (COVID-19) from a rural county of approximately 25,000 persons; these cases were the first identified in this county. The two cases occurred in a husband and wife; the husband is the pastor at a local church (church A). The couple (the index cases) attended church-related events during March 6-8, and developed nonspecific respiratory symptoms and fever on March 10 (wife) and 11 (husband). Before his symptoms had developed, the husband attended a Bible study group on March 11. Including the index cases, 35 confirmed COVID-19 cases occurred among 92 (38%) persons who attended events held at church A during March 6-11; three patients died. The age-specific attack rates among persons aged ≤18 years, 19-64 years, and ≥65 years were 6.3%, 59.4%, and 50.0%, respectively. During contact tracing, at least 26 additional persons with confirmed COVID-19 cases were identified among community members who reported contact with church A attendees and likely were infected by them; one of the additional persons was hospitalized and subsequently died. This outbreak highlights the potential for widespread transmission of SARS-CoV-2, the virus that causes COVID-19, both at group gatherings during church events and within the broader community. These findings underscore the opportunity for faith-based organizations to prevent COVID-19 by following local authorities' guidance and the U.S. Government's Guidelines: Opening Up America Again (2) regarding modification of activities to prevent virus transmission during the COVID-19 pandemic.
